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Examining Constructs of the Health Belief Model As Predictors of Haitian Men's Intention Regarding Prostate Cancer Screening D

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Examining Constructs of the Health Belief Model As Predictors of Haitian Men's Intention Regarding Prostate Cancer Screening D EXAMINING CONSTRUCTS OF THE HEALTH BELIEF MODEL AS PREDICTORS OF HAITIAN MEN’S INTENTION REGARDING PROSTATE CANCER SCREENING DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Nursing Barry University Jhonii Price Louis, II 2016 EXAMINING CONSTRUCTS OF THE HEALTH BELIEF MODEL AS PREDICTORS OF HAITIAN MEN’S INTENTION REGARDING PROSTATE CANCER SCREENING by Jhonii Price Louis, II 2016 APPROVED BY: ________________________________ Ferrona A. Beason, PhD, ARNP Chairperson, Dissertation Committee ________________________________ Claudette R. Chin, PhD, ARNP Member, Dissertation Committee _________________________________ Jessie M. Colin, PhD, RN, FRE, FAAN Member, Dissertation Committee Program Director, College of Nursing and Health Sciences _________________________________ John McFadden, PhD, CRNA Dean, College of Nursing and Health Sciences Copyright by Jhonii Price Louis, II, 2016 All Rights Reserved Abstract Background: The most recent report of Global Burden of Cancer (GLOBOCAN) indicated the incidence rate of prostate cancer in Haiti as 38.6 and the mortality rate as 32.3 per 100,000. The literature supports a high correlation between early prostate cancer screening and low mortality rate from the disease. Yet, the participation of Haitian men in prostate cancer screening remains low (Kleier, 2010). The literature has a lack of research on this matter, which presented the gap to be examined. Purpose: The purpose of this study was to determine which of these selected constructs of the Health Belief Model (perceived susceptibility, perceived benefits, and perceived barriers) are predictors to the intention of Haitian men regarding prostate cancer screening. Other modifying variables were also considered as predictors to the outcome variable. Theoretical Framework: The Health Belief Model (HBM) was utilized as the primary guide for the study; the Purnell Model for Cultural Competence served a complementary lens to account for any cultural gap studying this population. Method: A correlational, predictive cross-section design was used to obtain a convenience sample in Haiti (N = 200). The Champion HBM scale was adapted and modified for prostate cancer; it was administered in Haitian Creole and French. Data were analyzed through descriptive, correlation, logistic regression, and the nonparametric Kruskal-Wallis ( H) analysis of variance (ANOVA) to determine predictive correlation among the variables. Results: Seven hypotheses were tested; all but one was supported. Perceived benefits were found to have a predictive relationship to Haitian men’s intent to screen for prostate iv cancer [ c 2 (3) = 14.47, p = .00 ]. Further, the nonsignificant Hosmer and Lemeshow statistic, c 2 (8) = 4.33, p = .83 supports that the data was a good fit for the model. No other variable was found to be significant. Conclusion: The findings from this study can be utilized by nurses and other healthcare professionals to generate and implement culturally appropriate interventions; consequently, these interventions will decrease the morbidity and mortality rates of prostate cancer among Haitian men in Haiti and abroad. v ACKNOWLEDGMENTS “Béni soit l'Eternel! ” Blessed be the Almighty God for taking charge and bringing along a superb team to guide me throughout this process. Such a journey can be taxing and fearful. It can interject doubts into one’s mind regarding one’s own ability, for it is a long and strenuous journey. However, I have remembered: 2 Timothy 1:7 “For God has not given us a spirit of fear but of power, of love and of a sound mind” and Philippians 4:13 “ I can do all things through Him who strengthens me.” These quotes have become my dictum during this journey and will remain so for the rest of my life. Besides the Almighty Father, I will be evermore grateful for the persistent unaltered support and love from my family, Shiin M. Louis and Claire S. Louis. Your patience and understanding have facilitated my will to go through this journey and pursue success. I thank you very much. I must also acknowledge every member of my extended family for their tolerance of my lack of presence in the family affairs during this journey. You have allowed me to fully focus on this member of the family: Me. Thank you. I will be eternally indebted to the “Dream Team”: My committee chair, Dr. Ferrona A. Beason for your leadership, guidance, and understanding; my committee members, Dr. Claudette R. Chin for being a mentor, and for your dedication and genuine interest in my work; and Dr. Jessie M. Colin for literally everything. You have given me the foundation to go through this process. To me personally, you have held many roles during this journey. I thank you for your expertise. I must also extend my gratitude toward Dr. JoAnn Kleier for being a pioneer on this particular topic concerning this population and for agreeing to come on board to help with the statistics of this study. vi To the founders of UPH, Mr. Serge B. and Mrs. Sandra Montes, I am particularly beholden to you. You have facilitated a task that others would consider impossible. You placed all your resources and your staff at my disposition and made my data collection seem stress free. In addition, I must certainly mention Mr. Johnson Jean-Louis, whom I call the manager. Thank you for toting me around the country. Your assistance was very much essential and appreciated. A world of thanks to the Rev. Pere Castel Germeil, the Academic Council President, and the entire staff of L’ Universite Polyvalente d’ Haiti (UPH). All was possible because of the collaboration of UPH. The UPH staff from Les Cayes deserves this special recognition for their hard work. Special thanks is extended to Mr. Viviens Andre Marc, Site Coordinator, Rev. Michel Emeste, Brother Charles Jouvenel, and Brother Alain Gaspard. Your service was beyond my expectation. Certainly, any long and laborious journey is psychologically demanding. A journey such as this definitely requires perpetual support. To Ms. Z. Pricelle George, you have been this constant from the very commencement. You have earned every praise or credit that is due to you. I am sincerely thankful to you for who you are and all that you do. That is what true family does! Although I felt alone several times on this journey, I must also acknowledge the wonderful fellow Miami cohort with whom I took this journey. They both directly and indirectly strengthened me along the way, letting me know that we all have flaws and the journey does not have to be perfect. Most importantly, they taught me that the journey does not have to be time limited or restricted. The essential goal is to arrive at the destination strong and proud. That was exactly my intention—STRONG and PROUD. vii Finally, I am sincerely thankful to my friend Roger Edouard for linking me to Dr. Jean A. Francois for his translation service. I thank you Dr. Francois; I was exceptionally gratified with your service. To anyone else not mentioned but played a role in helping me with this accomplishment, I sincerely thank you. Your contribution was surely valuable and appreciated. Let us all celebrate this end result. “Being confident of this very thing, that He who began a good work in you will carry it unto completion….” Philippians 1:6 viii DEDICATION “The lives of those who pass away remain in the memory of those who live and love them.” This dissertation is first dedicated to my beautiful daughter, Khonii S. Louis, who left us too soon on 10/10/2010. You were and still are known to us as the love butterfly. Your philosophy of loving everyone was plain and simple. It only dictates that the world does not have to be so complicated because “Love endures it all.” Thank you for loving me unconditionally. Regardless of my flaws, you just wanted me to be your papa. Thank you. With your spirit, I shall continue to soar high. “Anyone who has given love will always live in another’s heart.” This dissertation is also dedicated to my dear mother, Lamercie Louis, another beautiful soul who left us too soon. You laid such a strong foundation; the result is apparent via the lives of your children. I thank you for giving me so much love until the end. Most importantly, you have taught me that “Hard work is real and working hard is freedom.” This is for you, mom. This dedication is also extended to my father, Anthony Louis. You have shown me repeatedly that a man must work hard in order to provide for his family. I used to wonder if it was ethical for men to take breaks. Your work ethic surely influenced my perception about life in general. I am sure this accomplishment of mine makes you proud. Thank you for being such a rock in my life; thank you for being there. Finally, this dissertation is dedicated to my entire family. As much as we are part of each other, my success is surely yours. In conclusion, this is dedicated to all Haitian men everywhere. This work was completed with you in mind. Special dedication goes out to all the participants of this study. Your input was key to the result of this work. Hence, this work would not be possible without you. THANK YOU! ix TABLE OF CONTENTS TITLE PAGE………………………………………………………………………………i SIGNATURE PAGE……………………………………………………………………...ii COPYRIGHT PAGE……………………………………………………………………..iii Abstract .............................................................................................................................. iv ACKNOWLEDGMENTS ................................................................................................
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